olo/Dc[M4]_3 1

Minutes of the 4th Meeting of the HKSAR Third Term of Wong Tai Sin District Council

(Summary Translation) Date: 6.5.2008 (Tuesday) Time: 2:30 p.m. Place: Conference Room, Wong Tai Sin District Office,

6/F, Lung Cheung Office Block, 138 Lung Cheung Road, Wong Tai Sin, Kowloon.

Present: Chairman: Mr. LI Tak-hong, MH Vice-chairman: Mr. WONG Kam-chi, MH, JP Wong Tai Sin District Council Members: Mr. CHAN Lee-shing Ms. CHAN Man-ki, Maggie Mr. CHAN On-tai Mr. CHAN Wai-kwan, Andie Mr. CHAN Yim-kwong, Joe Mr. CHOI Luk-sing, MH Mr. CHOW Ching-lam, Tony, MH Mr. CHUI Pak-tai Mr. HO Yin-fai Mr. HUI Kam-shing Mr. KAN Chi-ho, BBS, MH Ms. KWOK Sau-ying Mr. LAI Wing-ho, Joe Dr. LAU Chi-wang, James, JP

olo/Dc[M4]_3 2

Mr. LEE Tat-yan, MH Mr. MOK Chung-fai, Rex Mr. MOK Kin-wing Mr. MOK Ying-fan Mr. SHI Lop-tak, MH Mr. SO Sik-kin Ms. TAM Yuet-ping, Celia Mr. TO Kwan-hang, Andrew Mr. WONG Kam-chiu Mr. WONG Kwok-tung Mr. WONG Kwok-yan Mr. WU Chi-wai, MH Absent with Apologies Mr. HO Hon-man Mr. LAM Man-fai, JP Mr. WONG Yat-yuk In attendance: Mr. CHEUNG Hau-wei, JP

Director of Buildings BD )

Mr. TANG Chung-ming

Sr Structural Engr/C4 BD )

Mr. T.C. LEUNG Sr Building Surveyor /Fire Safety

BD

Mr. TSE Ping-ho Sr Division Offr FSD Mr. LAU Sing-wah Division Offr (Building

Improvement & Support) 1 FSD

Re: Item III(i)

Mr. SIU Yu-bun, Alan, JP

Dep Secy for Commerce & Econ Dev (Communication & Technology)

CEDB )

Mr. CHAN Wai-ming, Thomas

Sr Telecommunications Engr (Advisory & Support)1

Office of the Telecommunications Authority

)

Re: Item III (ii)

Dr. CHOW Yat-ngok, York, SBS, JP

Secy for Health and Food FEB )

Mrs. LEE Suk-yee, Sandra, JP

Permanent Secy for Food and Health (Health)

FEB )

Ms. Christian AU Assistant Secy for Food and Health (Health)

FEB

Re: Item III (iii)

olo/Dc[M4]_3 3

Mrs. TAM CHEUNG Kwei-ying, Dorothy

Regional Officer (Kowloon East/Sai Kung)

ICAC )

Mr. W. L. CHAN ICAC Officer ICAC )

Re: Item III (iii)

Mrs. Teresa WONG, JP DO (WTS) WTSDO Mr. David Michael GUNTON

District Commander(WTS)

HKPF

Mr. MA Kam-chuen Ch Mgr/M (KE) HD Miss Cecilla LI DSWO (WTS/SK) SWD Mr. WONG Wai-wan Dist Env Hygiene Supt(WTS) FEHD Mr. WONG Kin-chung Dist Leisure Mgr (WTS) LCSD Mr. LAU Kin-kwok Sr Transport Offr/(WTS) TD Mr. MAK Chi-biu Sr Engr/5 (Kln) CEDD Miss CHAN Tsz-ki, Trinky

ADO (WTS) WTSDO

Mr. Patrick CHUNG SEO (DM) WTSDO Mr. TING Tin-sang

SLO 1 WTSDO

Miss. Shirley WU

SLO 2 WTSDO

Mr. Nathan YAM EOI (DC) WTSDO Secretary: Mrs. Teresa SOH SEO (DC) WTSDO Opening Remarks The Chairman welcomed everyone to the fourth meeting of the Wong Tai Sin District Council (WTSDC). 2. The Chairman welcomed representatives of the Buildings Department who attended the meeting:

(i) Mr. CHEUNG Hau-wei, JP Director of Buildings (ii) Mr. TANG Chung-ming Senior Structural

Engineer/C4 (iii) Mr. T.C.LEUNG Senior Building

Surveyor/Fire Safety

olo/Dc[M4]_3 4

3. The Chairman told Members that there were three Members who would be absent from the meeting with apologies, namely, Mr. HO Hon-man, Mr. LAM Man-fai, JP, and Mr. WONG Yat-yuk. They had sent written notification to the Secretariat before the meeting. Members noted the absence notice of the three Members. Schedule for the Discussion of the Agenda 4. The suggested schedule for the discussion of the agenda for the fourth WTDC meeting was placed on table for reference. As Dr. CHOW Yat-ngok, York, SBS, JP, Secretary for Food and Health would arrive at 4:30 pm to present the consultation document on healthcare reform, and so the Chairman asked Members to keep the time limit of the first two agenda items, and speak as precisely as possible. Members showed no objection to the time schedule. I Confirmation of the Minutes of the 3rd Meeting of WTSDC on

11.3.2008 5. The minutes of the 3rd meeting of WTSDC held on 11.3.2008 were confirmed without amendment. II Matters Arising from the 3rd Meeting of WTSDC (WTSDC Paper 32/2008) 6. Members noted the paper. III (i) A Visit to WTSDC by Director of Buildings 7. The Chairman welcomed Mr. CHEUNG Hau-wei, JP, Director of Buildings; Mr. TANG Chung-ming, Senior Structural Engineer/C4 and Mr. T.C. LEUNG, Senior Building Surveyor/Fire Safety to attend WTSDC meeting to discuss buildings affairs with Members, and also welcomed Mr. TSE Ping-ho, Senior Division Officer and Mr. LAU Sing-wah, Division Officer(Building Improvement and Support)1 of the Fire Services Department to attend the meeting. 8. Mr. CHEUNG Hau-wei introduced the work and the future plan of the Buildings Department (BD). BD was mainly responsible for the safety work of private buildings, including:

olo/Dc[M4]_3 5

(i) To ensure the safety of new buildings and existing

buildings: BD was responsible for approving plans and examining whether the height and plot ratio of buildings complied with respective outline development plans; supervising the safety and quality of buildings after completion; examining and inspecting the hygiene and design safety of works site and issuing occupation permits. For new buildings, investigation would be carried out upon receipt of complaints, and repair orders would be issued to buildings in bad repair or with imminent danger.

(ii) Demolition of Illegal Structures: In view of the great number of illegal structures in Hong Kong, BD would prioritize the demolition of buildings based on their degree of danger and duration. New illegal structures with imminent danger would be considered as priority ones. As regards other stand-over cases, BD would issue “warning notices” in accordance with “Buildings Ordinance”. If owners failed to demolish the illegal structures before the designated time, BD would register the “warning notices” against the title of the subject premises in the Land Registry. BD would take legal action against owners failing to demolish the illegal structures;

(iii) Renewing and Improving Fire Fighting Equipment: BD actively strengthened the fire fighting equipment of existing buildings in accordance with the “Fire Services Ordinance” and would handle the matter with reasonable and flexible approach;

(iv) Demolition of Rooftop Illegal Structures: This mainly targeted at the dangerous rooftop structures, especially at single staircase buildings with one fire escape. The problem of illegal rooftop structures had aroused public’s concern.

(v) Handling of Seepage: BD set up a joint office with the Food and Environmental Hygiene Department (FEHD) to handle water seepage in July 2006. Some seepage problems were solved, and improvement was still

olo/Dc[M4]_3 6

required for the work. The Office of the Ombudsman issued a report about water seepage earlier, which requested the two departments to strengthen communication and put forward a number of proposals. BD considered the proposals sensible and would follow up the issue; and

(vi) Demolition of Discarded Signboards: In view of the importance of signboards in commercial market, BD could not adopt a radical approach in demolishing the signboards, which would bring an adverse impact on the society. As such, BD would firstly demolish the large-sized signboards in busy districts and adopt a gradual approach in carrying out demolitions. They aimed at demolishing at least 1200 each year to protect the safety of the public.

The future plan of BD was as follows:

(i) Implementing Minor Works Registration and Control Scheme: The existing legislation required that Authorised Persons (AP) and registered engineers be commissioned to carry out the minor works, and the examination by the related parties was required. This not only involved complicated procedures but also incurred huge cost, people would inevitably take the risk and erect illegal structures. Through minor works contractors registration scheme, BD would categorise contractors and simplify procedures in accordance with the complexity and scale of minor works, so that the public could carry out buildings maintenance, indoor alteration and additions legally. This could minimize illegal structures and increase the number of legal minor works contractors, thus promoting healthy competition in the industry; and

(ii) Implementing Mandatory Building Inspection Scheme: The proposal was widely consulted over the past two years and won the general support of the public. BD intended to submit the proposal to the Legislative Council (LegCo) in the end of 2009 for enacting the legislation.

olo/Dc[M4]_3 7

To assist the elderly and the low-income group to implement building maintenance and demolition, a number of Government departments had provided the associated assistance, including:

(i) Interest-free loan scheme of the BD for building maintenance and demolition;

(ii) Loan subsidy scheme provided by the Hong Kong Housing Society (HKSC) as the maintenance subsidy for the public area in a building;

(iii) Loan subsidy scheme provided by the Urban Renewal Authority to assist the owners to carry out rehabilitation;

(iv) Building Maintenance Grant Scheme for Elderly Owners would be implemented by HKSC in the end of May, the amount of subsidy in five years would amount to $40,000. This could be used for carrying out buildings maintenance, renewing fire fighting and electricity and mechanical equipment. Owners could make the application if they fulfilled the means and assets test, and the property was for self-occupation.

(Mr. CHUI Pak-tai arrived at the meeting at 2:55 pm) 9. The Chairman said that the paper submitted by Mr. LEE Tat-yan, MH, titled “Views and Recommendations about Effective Control of Private Buildings” (Annex 1) was on table, he asked Mr. LEE Tat-yan to present the paper first before other Members made their speeches. 10. Mr. LEE Tat-yan said that the five problems stated in the paper were the common problems which front-line Members came across when they contacted residents. The main points were as follows:

(i) Lack of Internal Coordination Relating to the Issue of Orders by BD: Take Yu Foo Building in San Po Kong as an example, the owners received five orders within three years, including the request for demolition of rooftop structures, building maintenance, removal of illegal structures and railings, which reflected the lack of internal coordination. The grass-root owners not only borne great economic cost, but also suffered persistent mental stress. He suggested that BD issued orders once

olo/Dc[M4]_3 8

and for all to rationalize the maintenance and management of the buildings.

(ii) Dubious Effect in Registering the Warning Notices Against the Title of the Subject Premises in the Land Registry: The registering system originally aimed at deterring those owners not complying with the demolition order. However, those buildings whose warning notices had been registered could still be brought and sold if parties involved were willing to, which indirectly allowed owners to get rid of their responsibilities to carry out immediate demolition. He suggested that BD carried out the review as soon as possible to strengthen the deterrent effect of the related legislation.

(iii) Different Standards for the Demolition of Illegal Structures: In removing rooftop structures or platforms of buildings, BD would allow some illegal structures to exist for a long time owing to the principle that buildings with no imminent danger would not be accorded priority.

(iv) Strengthening Publicity: He suggested that in enacting or implementing new legislation, BD should allow at least one year for carrying out publicity education apart from publicity through different media, so that the public could adapt to it and understand the contents of the legislation.

11. Mr. CHAN Yim-kwong, Joe said that the district which he served had a lot of old private buildings, hence greatly affected by different projects implemented by BD. Residents were always put in a dilemma when implementing the order of BD. For example, the design of some buildings were made according to the standard forty years ago, no place had been spared for installing gates. Along with the changes of society, tenants installed gates for security but subsequently they received removal orders from BD. He understood that BD acted in accordance with “Fire Services Ordinance”, but such arrangements made tenants at a loss. On the other hand, BD asked some buildings to seal staircase windows for fire prevention in accordance with “Fire Safety (Buildings) Ordinance”(Chapter 572), however owners reflected that when they moved in the flats, they were allowed to open windows of staircases, moreover as staircases were

olo/Dc[M4]_3 9

the main passageways for residents, a sealed environment would affect their daily lives. He wanted to understand the design requirement. 12. Mr. CHOI Luk-sing, MH said that he appreciated that various measures taken by BD had greatly reduced the fire problems in Hong Kong. However, there were a number of pre-war stand-alone buildings, and even with the assistance of Government departments, it was difficult to form an Owners’ Corporation (OC), and that led to a variation of maintenance standard of buildings. He reminded BD to keep a uniformed standard when carrying out demolition work to avoid segregation of residents. On the other hand, he was concerned with the extension of signboards towards the middle of road in Nathan Road. He asked if these signboards met the standard. 13. Dr. LAU Chi-wang, James, JP put forward two proposals. He quoted a real case in which a large signboard had been installed at the side of a canopy of a building, the long term impact of the wind had cracked the canopy. OC submitted a written complaint to BD, but BD disregarded the complaint with the pretext that “there was no immediate danger”. On the other hand, the Joint Office under the jurisdiction of BD and FEHD was set up to solve water seepage at a quicker pace, he could not understand why the staff of the Joint Office still wasted a lot of time in making an application to the court for obtaining a warrant to enter the house. He suggested that BD adopted a more flexible approach in enforcing the ordinance to avoid putting the incidental before the fundamental. 14. Mr. SO Sik-kin agreed to the implementation of mandatory building and window inspection scheme to safeguard the safety of residents. He said that staff of the Joint Office once participated in the meeting of WTSDC, and the Members were optimistic about the solution for water seepage after discussion. However, he always received complaints from residents about the improper handling of water seepage, which was disappointing. When BD staff could not obtain warrant to enter the flat for investigation, the related departments must review the system to find a way out. 15. Mr. MOK Ying-fan commented that he could not understand why water seepage still could not be solved with the advanced development in technology. As the Director of BD had just mentioned the investigation report of the Office of Ombudsman which stated that there was “room for development”, he hoped that BD could provide the time table for improvement and stipulate performance pledge to help owners solve the problem.

olo/Dc[M4]_3 10

16. Mr. WONG Kam-chiu said that he came across a case in which there was serious stripping and seepage at the outer wall of a private building, however OC found that the ownership of the outer wall was still with the developer, and so they wrote to BD to lodge the complaint. Later BD replied that the developer had not enjoyed the outer wall and thus asked OC to repair it on their own, he wanted to know the reason. (Ms. CHAN Man-ki, Maggie arrived at the meeting at 3:15pm.) 17. Mr. CHEUNG Hau-wai gave thanks to Members for their questions and views and he gave a consolidated reply as follows:

(i) Preliminary and in-depth investigation would be carried out for solving water seepage. Preliminary investigations were conducted by FEHD for finding the source, if unsuccessful, BD would follow up. Joint Office had launched a three-year pilot scheme since July 2006 and it had been in operation for only one and a half year. It was still in the exploration stage and more experience was required. He agreed that the Joint Office lacked the performance pledge and would contact FEHD to discuss the issue and work out one.

(ii) The efficiency of the Joint Office in solving seepage problem was far from satisfactory as there were a lot of procedural problems that could not be solved solely by technology. To solve water seepage problem, the source must be found first to ascertain the maintenance responsibilities. As the work of tracking water source was comparatively new, even BD outsourced the work, each party must gain experience so as to improve time control and then map out a more effective management model. On the other hand, all the investigation and testing must be conducted in the house. The available time of tenants must be taken into account, and owners must be willing to let staff of the Joint Office get in. BD was authorized by law to enter the house for investigation, but that power was applicable to matters relating to illegal structures under “Buildings Ordinance”. If the purpose behind the entry in the house was to handle seepage, it must be done in accordance with “Public Health and Municipal Services

olo/Dc[M4]_3 11

Ordinance”. Notice must be issued first, and warrant could only be applied when the notice was found null. Although the procedures were complicated and were more time consuming, it was still the starting point of seepage investigation.

(iii) As regards the internal coordination on issuing orders, it was because different ordinances were finalized at different times. As such, different orders were issued at different times, however BD would try to coordinate.

(iv) As there were a lot of illegal structures, BD would decide the priority of demolition based on the degree of danger and the age of buildings. Henceforth, there were two implementation methods: one of them was issuing removal orders that demanded owners to demolish the illegal structures immediately; another one was issuing warning notices to owners and telling them that the structures were illegal, and then the warning notices would be registered against the title of the subject premises in the Land Registry, in this way, owners and buyers would be notified, but the transaction could not be controlled by BD. If illegal structures must be demolished immediately, BD would issue removal orders instead of warning notices.

(v) As regards strengthening the publicity of the scheme, BD agreed that any new measures required extensive consultation, and sufficient time was required for public education. The proposed minor works contractors registration and management scheme had been submitted to the LegCo for approval. It was hoped that after the main legislation had been passed in July, the subsidiary legislation could be passed in the end of the year. Then the related details of publicity could also be handled.

(vi) BD adopted two basic criteria for the installation of gates: one was that the gates could be open towards the exterior, another one was that no keys were required for opening the gates. As the design of gates was related to fire escape, he hoped that the buildings could comply with the criteria as far as possible.

olo/Dc[M4]_3 12

(vii) As regards the window of staircases in old buildings,

there was no requirement for the provision of the window of the fire escape with adequate fire resistant capability. However after the occurrence of fire incidents in Mei Foo Sun Chuen and Golden Court, BD found that there was a need to strengthen fire resistant capability of the window of the fire escape according to the existing criteria, and would ask owners to replace those windows not complying with the existing standard, and install those fixed windows that were proved to have suitable fire resistant capability. But BD would take a flexible approach according to situations.

(viii) BD endeavored to demolish illegal rooftop structures in single-staircase buildings for the safety of tenants. As there was only one fire escape for tenants in single-staircase buildings, they would go up to flee for their lives if the downward route was blocked. As such, BD must ensure that the structure of rooftop was safe to avoid the occurrence of tragedy. BD had sought the assistance of HKSC for setting up OC to help owners carry out repairs and demolition.

(ix) In relation to the complaint lodged by the public about the variation in the demolition criteria, it was due to the related policies. The demolition priority would be decided based on the degree of danger and age of buildings, and so illegal structures erected within one year must be demolished immediately to contain the problem. Therefore, it might lead to a situation in which on the same building platform, some illegal structures required to be demolished first, while some others could be held over.

(x) The principle under which BD abandoned the signboards was to assess if they posed danger to the surroundings, otherwise signboards could be allowed for commercial publicity. With the finalization of minor works contractors registration and control scheme, contractors could provide simple way for the public to erect signboards using the technology and

olo/Dc[M4]_3 13

measurement required in the system. With the adoption of two-pronged strategy, it was hoped that the problem could be solved thoroughly.

(xi) As regards the case in which there was the spalling of concrete at the external wall and water seepage mentioned by Mr. WONG Kam-chiu, he considered that there was imminent danger and undertook to handle it immediately; as regards the case in which signboards created fissure at a building’s canopy mentioned by Dr. LAU Chi-wang, James, there was room for review and BD would follow up the case. (Post-meeting note of the Secretariat: Representatives of BD had collected the information about the cases mentioned by Mr. WONG Kam-chiu and Dr. LAU Chi-wang, James. As the two buildings involved were situated in Kowloon City, BD had referred the cases to the BD staff in that district for following up.)

18. The Chairman said that the time for discussing this agenda was up, as Mr. SHI Lop-tak, MH; Mr. WONG Kam-chi, MH, JP; and Mr. SO Sik-kin intended to deliver speeches, and so he suggested that BD recorded the views for following up afterwards. 19. Mr. SHI Lop-tak, MH enquired how to apply for exemption if surveyor had proved that the illegal structures had no imminent danger. On the other hand, he also suggested seeking the assistance from contractors in tracking the source of seepage, and passing the result to BD to enhance the efficiency. 20. Mr. WONG Kam-chi, MH, JP wanted to know the reason behind the inconsistent criteria for removing the illegal structures in “designated target buildings”. 21. Mr. SO Sik-kin said that he was disappointed with the attitude with which the outsourcing contractors handled seepage complaints as they always used the pretext “unable to track the source” to close the case perfunctorily. 22. In response to the enquiry of Mr. WONG Kam-chi, Mr. CHEUNG Hau-wai replied that the demolition of illegal structures in “designated target buildings” was conducted according to the priority prescribed by the policy, those illegal structures posing threat to life and

olo/Dc[M4]_3 14

property or with imminent danger and newly built illegal structures would be handled with priority. If the illegal structures in the “designated target buildings” were not within this category, they would be held over. (Mr. CHAN Lee-shing arrived at the meeting at 3:45pm.) 23. The Chairman thanked Mr. CHEUNG Hau-wai and BD’s representatives for coming to WTSDC. He hoped that BD would listen to the views of Members and follow up the cases. If Members had other cases which BD had to follow up, they could contact BD directly. (Mr. CHEUNG Hau-wai, Mr. TANG Chung-ming, Mr. T.C.LEUNG, Mr. TSE Ping-ho and Mr. LAU Sing-wah left the meeting at this juncture.) III (ii) Implementation of Digital Terrestrial Television (WTSDC Paper 33/2008) 24. The Chairman welcomed representatives of the Government and Office of the Telecommunications Authority, including Mr. SIU YU-bun, Alan, JP, Deputy Secretary for Commerce & Economic Development (Communication & Technology), Commerce and Economic Development Bureau (CEDB) and Mr. CHAN Wai-ming, Thomas, Senior Telecommunications Engineer (Advisory & Support) 1,Office of the Telecommunications Authority (OFTA) who attended the meeting for this agenda. 25. Mr. SIU Yu-bun introduced the latest progress of the broadcast of digital terrestrial television (DTT) with audio-visual aid. The highlights were as follows:

(i) Owing to the topography in Hong Kong, problems of “ghosting” and “snowing” in analogue broadcasting existed in some regions. Hong Kong entered the new era of DTT broadcasting on 31 December 2007. The public could solve the problem of “snowing” and “ghosting” thoroughly if they received DTT broadcasting. At the same time, DTT broadcasting not just provided multi-channel broadcasting, but also provided new services like high definition television (HDTV), interactive television and datacasting.

(ii) Two domestic free television stations launched DTT

olo/Dc[M4]_3 15

broadcasting on 31 December 2007 with 13 channels. Apart from four television channels, 24-hour free television channels, 24-hour HDTV channels and Mainland television channels would also be provided for the choice of the public.

(iii) If Members of the public wanted to watch digital television, they could check the on-line database of the OFTA to confirm if their residential buildings were within the coverage. At the same time, the In-Building Coaxial Cable Distribution System (IBCCDS) needed to be upgraded.

(iv) In terms of coverage, the two local free television stations now use the transmission station in Hong Kong at Temple Hill for DDT broadcasting to serve around 50 % of the population, including Wong Tai Sin. Five more principal television stations would be built in early August 2008 to expand the coverage to all 18 districts, serving about 75% of population. OFTA launched on-line database on 15 January 2008, illustrating the coverage of DDT broadcasting for the reference of the public.

(v) The Housing Authority (HA) announced that it would upgrade all Communal Aerial Broadcast Distribution (CABD) system in public housing estates for all households to watch digital television. All the buildings within the coverage had completed their upgrading of CABD, the remaining works would be completed in August 2008. CABD in the new housing estates could all receive DDT broadcasting.

(vi) According to OFTA, more than 20% of private buildings had completed their upgrading of CABD, 50% of private buildings would implement the said works within one year.

(vii) As regards how to upgrade IBCCDS which were connected to the Hong Kong Cable Television Limited (Cable TV) network for DDT reception, Cable TV operators said that if Cable TV was the system operator, owners/building management office could approach

olo/Dc[M4]_3 16

Cable TV for carrying out the said works, and owners/building management office would bear the costs (the costs would be the same as required by general contractors). If the upgrade was taken up by other operators, owners/building management office could approach Cable TV to provide free services to connect digital television signal to the network system of Cable TV.

(viii) There was no interference between DDT broadcasting and analogue television broadcasting. OFTA had received about 250 cases reporting suspected interference and had followed up all cases. Investigation result showed that for most of the cases, the reception was satisfactory, and the problems of the remaining cases were mainly caused by the inadvertent faults when the CABD system was upgraded for DTT reception. OFTA had provided technical advice to help solve the reception problem.

(ix) DDT receiver was new electronic product with which the public was not familiar. To protect the rights and interests of consumers, OFTA had launched Voluntary Labelling Scheme to encourage manufacturers to register their products with OFTA. Label would be attached on products complying with the standard stipulated by OFTA. Although the scheme was voluntary in nature, because of the fierce competition, consumers would not choose products without such labels. Manufacturers would hence be compelled to join the labeling scheme.

(x) A number of receivers were available in the market, and the set-top boxes for DDT cost from $1,700 to $2,700 with some special functions. On the other hand, some pay television stations also launched certain schemes for the public to rent their receivers when choosing their pay services, and some course organizers also offered receivers to the public when they enrolled for the courses. It was expected that the products would be more diversified and cheaper.

(xi) OFTA would promote and publicise DDT through

olo/Dc[M4]_3 17

television, radio, pamphlets, posters and dedicated website to enhance the understanding of the public. OFTA would also hold technical briefings on reception for CABD operators and building management companies. On school education, Radio Television Hong Kong (RTHK) had produced DVD for distribution in schools. On the other hand, OFTA would also cooperate with the Consumer Council to issue a number of topical reporting relating to DDT in the monthly bulletin “Choice”.

(xii) OFTA would join hands with the Environmental Protection Department (EPD), voluntary agencies and electrical appliances merchants association to strengthen recovery, reuse and recycling of old television sets.

(xiii) OFTA would step up promotion in districts, including holding briefings in the District Councils (DCs), promoting DDT through the network of DCs, collecting public views towards DDT broadcasting and promoting the latest information about digital coverage in the district. At the same time, private property management companies would also be encouraged to complete the upgrading work of CABD systems as quickly as possible.

26. The Chairman asked Members to give their views towards DDT broadcasting. 27. Mr. SO Sik-kin supported the implementation of labeling scheme of receivers and suggested making it mandatory, so as to prevent the public from buying receivers not complying with the standard. In view of the close relationship between Mainland China and Hong Kong after the reunification, the provision of only Channel 4 of China Central Television Channel (CCTV) was far from enough. Indeed, there were more than 10 different channels in CCTV with different kinds of programmes, all of them should be provided to the public. 28. Mr. SHI Lop-tak, MH considered that with the advance in technology, the promotion of DDT was necessary. However he pointed out that there was a need to pay attention to the environmental protection

olo/Dc[M4]_3 18

problem arising from the disposal of old television sets. He enquired if OFTA had cooperated with different organizations to recover old television sets, and if it was possible to install one central receiver at the position where antenna was erected, so that each household had no need to spend money to buy receiver. 29. Mr. HO Yin-fai enquired about the difference between “basic-tier” and “higher-tier” receivers. He knew that once users of Cable TV in estates cancelled the contract for Cable TV services, Cable TV failed to recover the original system for users, as a result, users could not watch programmes of the two free television stations. On the other hand, he knew that some salesmen went to public housing estates to sell set-top boxes which cost more than $2,700, claiming that the products were approved by the Government. He worried that members of the public would be misled. 30. Mr. MOK Chung-fai, Rex appreciated that DDT broadcasting adopted the transmission standard of Mainland China, which was not compatible with television sets produced in other countries, and so it was necessary to install receiver for decoding. He commented that it was also important to publicize green message while implementing DDT broadcasting. It was important to promote environmental protection in schools as students were more receptive to new knowledge. 31. Mr. CHOI Luk-sing, MH pointed out that since the reconstruction of public housing estates in Tsz Wan Shan, households in Yuk Wah Street and Fung Wong Sun Tsuen had difficulty in receiving free television broadcasting as their flats were blocked by the tall buildings, and they had to pay for free television programmes through Cable TV. He wanted to know if it was technically feasible to assist those households living in low level or lower storeys to receive the television broadcasting signal clearly. 32. Mr. WONG Kam-chiu said that works had been carried out in the building he resided, and so households in his building could watch HDTV programmes of Television Broadcasts Limited (TVB) and Asia Television Limited (ATV). Nevertheless, Cable TV and NOW TV said that decoders had to be installed for watching their programmes, he wanted to know the reason. 33. Mr. SIU Yu-bun, Alan, JP gave a consolidated response to the enquiries and opinions of Members:

(i) Although labeling scheme for receivers was conducted

olo/Dc[M4]_3 19

on a voluntary basis, reputable or established sellers would sell receivers with label on them. There were a variety of labeled receivers in the market with reasonable price. The public would not choose receivers with no label on them, and so there was no need to push sellers to join the scheme.

(ii) ATV had allocated a DDT channel for broadcasting free programmes from Channel 4 of CCTV, the public could watch programmes from Channels 4 and 9 of CCTV through pay channels. As DDT would provide more channels, plus the cooperation between two televisions and CCTV, many more CCTV programmes would be broadcast.

(iii) OFTA would issue unified carrier license which did not differentiate Fixed Telecommunications Network Services (FTNS) or mobile carriers. OFTA would incorporate provisions in the license to regulate service providers to safeguard the interests of consumers in signing telecommunications services contracts.

(iv) In relation to disposal of old television sets, OFTA would strengthen publicity and promotion of environmental protection, on the other hand, all Members could also explain to members of the public that if they were satisfied with the resolution, they could still use old television sets to broadcast DDT programmes without having to buy new television sets. OFTA would join hands with EPD and voluntary organizations to implement territory-wide recovery scheme and would study with electrical appliances traders to see if they could provide free recovery services for old television sets. The recovered television sets would be handled properly to reduce the electronic waste in landfills.

(v) Due to technical problems, standardized decoding procedures could not be conducted at the position in the buildings where antennas were installed, at present, users were still required to purchase receivers to watch DDT.

olo/Dc[M4]_3 20

(vi) “Basic-tier” receivers could receive the four programme channels simulcast by ATV and TVB, while “Higher-tier” receivers could receive all channels for DDT programmes. All receivers on sale in the market were “high-tier” ones-There were no “basic-tier” receivers.

(vii) The public could seek help from the Consumer Council if they had queries about the cancellation of Cable TV contracts. Queries about telecommunications could be referred to OFTA for following up.

(viii) As regards the sale of receivers in public housing estates by sales agents, Members could refer the cases to HA for strengthening estate management. Members could explain to the public on behalf of the Government that the Government had not approved individual companies or sale agents to sell receivers door to door, products attached with the approved label of OFTA would be sold in the market instead. If necessary, OFTA could explain to the public through district newspapers.

(ix) The Government took the market-driven approach to decide the transmission standard of DDT. After deliberate consideration with the trade, the two domestic free television stations suggested that they would adopt the standard developed by Mainland China. The said suggestion would facilitate the mutual coordination between the standards in Hong Kong and Mainland China, while DDT products developed by electrical appliances traders could also be sold in the Mainland market. The existing standard was not chosen by the Government, but was market-driven, which could best promote the development of DDT.

(x) The Government attached great importance to the publicity of environmental education. On school education, RTHK would provide education information about DDT to schools.

(xi) As TVB and ATV were free television stations, while

olo/Dc[M4]_3 21

Cable TV and NOW TV were pay channels, and so services provided by them would be different.

(xii) Satellite TV sent out signals through satellite, while Cable TV and Now TV sent out signals through underground network. DDT was of terrestrial broadcasting, and so it was called digital terrestrial television, briefly called DDT.

34. Mr. CHAN Wai-ming, Thomas explained that owing to urban renewal and the construction of more high-rise buildings, the reception of television signals in Yuk Wah Street and Fung Wong Sun Tsuen was relatively poor because of blockage of signals. Owing to the topography of Hong Kong and locations of high rise buildings, television signals in other districts was also blocked and reception was affected. With the installation of more broadcasting stations of DDT, it was hoped that reception of television signals could be improved, “ghosting” and “snowing” could be reduced and quality of the broadcasting could be improved. Further problems could be referred to OFTA for help. 35. Mr. WONG Kam-chiu said that although TVB claimed the simulcast of both analogue and digital broadcasting, based on experience, there was a lapse of 20 seconds for the broadcast of the same picture. He wanted to know the reason. 36. Mr. SIU Yu-bun explained that as digital broadcasting involved decoding procedures, and so there was a lapse of time for the broadcast of the same picture between the simulcast of digital and analogue broadcasting. 37. The Chairman thanked Mr. SIU and Mr. CHAN for attending the meeting and asked them to note and follow up the views of Members. The Chairman announced an adjournment of 15 minutes. (Mr. SIU Yu-bun, Mr. CHAN Wai-ming, Mr. CHOI Luk-sing, Mr. KAN Chi-ho, Mr. LAI Wing-ho, and Mr. WONG Kwok-tung left the meeting at this juncture. Mr. CHAN On-tai arrived at the meeting at 4:40pm.) III (iii) Consultation Document on Health Care Reform (WTSDC Paper 34/2008)

olo/Dc[M4]_3 22

38. The Chairman welcomed Dr. CHOW Yat-ngok, York, SBS, JP, Secretary for Food and Health; Ms. LEE Suk-yee, Sandra, JP, Permanent Secretary for Food and Health (Health) and Ms. Christine AU, Assistant Secretary for Food and Health (Health) for attending the meeting, and invited Dr. CHOW to present the paper. 39. Dr. CHOW Yat-ngok, York said that the “Healthcare Reform Consultation Document on Your Health Your Life” had been issued for seven and a half weeks, and they had attended more than 70 discussion sessions. In mid June, they would have attended approximately 140 briefings and the Food and Health Bureau (FHB) had set up the website “www.bestrong.gov.hk” to receive the views of the public about healthcare reform and financing options. So far, more than 580 e-mails were received to express different views. On the other hand, he also visited 18 District Councils (DCs) to present the consultation document, and WTSDC were the tenth DCs which he visited. FHB would consolidate the findings after the close of the consultation period on 13 June, 2008. As regards the direction of reform in healthcare put forward by the Government, there was no great dissension so far, but the details and concrete options would need to be discussed. FHB adopted an open mind towards the financing options and would listen to more views before making a decision. 40. Ms. LEE Suk-yee, Sandra presented “Healthcare Reform Consultation Document” with audio-visual aid. The consultation document had two parts, one was the four options for healthcare reform, another one was the six supplementary financing recommendations, the highlights were as follows:

(i) The four healthcare reform options addressed the inadequacy of the existing medical system to improve the level and quality of medical services provided to the public. In the market structure, a balance between public and private healthcare services could be struck; preventive care could be provided to the public to strengthen their health and improve their daily living habits; electronic health record system could be enhanced to develop sharing of record as the medical infrastructure; and the existing public healthcare safety net could be improved.

(ii) Reform option (1) was to enhance primary care for the purpose of establishing a family doctor register. This register could help strengthen preventive care for

olo/Dc[M4]_3 23

different age/gender groups with emphasis on preventive care. This register also helped establish a sustainable relationship between patients and family doctors to improve the health of the public and reduce the burden on hospital services. On the other hand, FHB would also implement family doctor system, as well as Health Care Vouchers to subsidise grass-roots citizens to use preventive care services in the private sector.

(iii) Reform option (2) was to promote partnership between public and private sectors. At present, there was a serious imbalance between public and private sectors regarding supply and demand, more than 90% of hospital beds were provided by public hospitals, and less than 10 % were provided by private hospitals. Apart from purchasing services from private hospitals, FHB also hoped to strengthen the cooperation with private doctors in private care, or even in terms of construction of hospitals in future. With multi-partite cooperation, it was hoped that private market could be expanded and their service level and transparency could be enhanced; and through healthy competition as well as sharing of opinions and experience, the standard and quality of health care services could be enhanced overall.

(iv) Reform option (3) was the development of electronic health record sharing. At present, the Hospital Authority (HA) kept several millions of health records.In the private market, each patient would consult different doctors and each doctor would not know the medical histories and drug records of their patients. If medical histories could be shared and patients got hold of the records, then the protection of the privacy could be enhanced, and resources could be saved. Quicker treatment could be provided as well.

(v) Reform option (4) was strengthening public healthcare safety net. The medical charges were levied on the basis of the income of patients, low-income groups and recipients of Comprehensive Social Security Assistance (CSSA) could be exempted from the payment or they could just pay partial fees. On the other hand, people with savings or from middle-income group could not

olo/Dc[M4]_3 24

enjoy the safety net when they had to receive costly or long term treatment. The present idea was that the patients would be protected by the safety net once the medial expenses had reached certain level of patients’ assets or assets of their families.

(vi) Some members of the public queried why there was a need for reform after the Government had put forward four healthcare reform options. Healthcare reform was a must, and the demand for healthcare services was on the rise. At present, one out of 8 citizens reached the age of 65 or above, by 2033, one out of 4 citizens would reach the age of 65 or above. Based on the data released by HA in 2006, the per capita medical cost of the elderly was six times more than those under 65 years old. As such, with population ageing and the increase in the demand for medical services, the medical expenditure would surely rise.

(vii) The Government attached great importance to the “supplementary” concept when it suggested supplementary financing. The Chief Executive had pledged to increase recurrent government expenditure for health and medical services from 15% at present to 17% in 2011-12, the two percent increase would amount to about $10 billion in expenditure. The Financial Secretary had also committed to draw $50 billion from the fiscal reserve as the start-up fund.

(viii) The Government would continue to uphold its long-established public healthcare policy that no one should be denied adequate healthcare through lack of means irrespective of the implementation of any financing options. The public could still enjoy the public healthcare services, only that they had more choices.

(ix) One of the supplementary financing options was “Social Health Insurance”, which was similar to tax revenue that required the working population to deposit certain percentage of their income to the social health insurance fund designated for healthcare use for the general population and wealth redistribution.

olo/Dc[M4]_3 25

(x) The second one was “Out-of-Pocket” Payments. Public

hospitals would raise the charges, but the disadvantage was that chronically-ill patients would have to bear greater cost.

(xi) The third one was “Medical Savings Accounts” through which individuals could make preparation for future medical needs. “Medical Savings Accounts” required that the working population put aside a certain percentage of their income for savings. There were two problems. One was that if a person could not use the savings while still at work, he or she would continue to rely on the medical services of public hospitals. If a person had used the savings while at work, he or she might not have sufficient savings to pay for medical expenses when reaching retirement age. On the other hand, medical savings could not serve the purpose of risk sharing.

(xii) The fourth option was “Voluntary Private Health Insurance”. More and more people had taken out medical insurance. However there was no control in the insurance market, and so there were a lot of drawbacks. For example, only the healthy persons were insured; and there was no guarantee for people having fallen ill or were older to renew the insurance policy or they might have to pay more premium.

(xiii) The fifth option was “Mandatory Private Health Insurance”. Mandatory private health insurance was different from voluntary private health insurance. Mandatory private health insurance covered risk sharing and was supervised by the Government. More people would join the scheme. Irrespective of age, gender and health conditions, the insured were charged the same premium; those who were ill could also take out medical insurance; those who were old or ill could renew the insurance policy. The premium would be lower with a greater number of insured persons. As “Mandatory Private Health Insurance” only required those at work to take out insurance, the retired persons who had the greatest need for insurance could not take out insurance, as they had no income, the protection would stop once

olo/Dc[M4]_3 26

the payment stopped. As such, the Government suggested the sixth option, i.e., “Personal Healthcare Reserve”.

(xiv) The sixth option was “Personal Healthcare Reserve”. It required that the designated groups of people would set aside part of the income for taking out mandatory private health insurance and part of the income for medical savings. The savings plus the proceeds of investment would be used to take out medical insurance and pay other medical expenses after retirement. This was a rather comprehensive option.

(xv) Among the six options, we had to consider the choice of the society and the value of judgement-whether people wanted to have more wealth redistribution or each of them made preparation for their future medical needs. Someone asked if they had to take out extra medical insurance when they had taken out private medical insurance. The Government had discussed this with the insurance sector, they suggested that private insurance could be converted to mandatory one as suggested in the option provided that the insured items were the same.

41. The Chairman thanked Ms. Lee for making the presentation, and asked Members to note two papers submitted on table, one by Mr. HUI Kam-shing and Mr. MOK Ying-fan of Hong Kong Association for Democracy and People’s Livelihood (annex 2) and another one from nine DAB Members of WTSDC (annex 3). The Chairman invited Mr. HUI Kam-shing and Mr. HO Yin-fai to introduce the two papers. 42. Mr. HUI Kam-shing introduced a paper titled as ‘Initial Comments of Hong Kong Association for Democracy and People’s Livelihood (ADPL) towards “Your Health Your Life Healthcare Reform” Consultation Document’. He said that the paper covered three parts: the principle and rationale behind the healthcare policies, the views towards consultation paper, and the emphasis that the mistakes made by “Mandatory Provident Fund” should not be repeated. He wanted to make the following supplementary illustration:

(i) The consultation paper pointed out that there was a need to change to cope with population ageing and the increase in

olo/Dc[M4]_3 27

medical expenditure. ADPL shared the view but thought that the extent of the changes deserved serious study. Hong Kong medical system was highly efficient, page 127 of the consultation document reflected that the overall medical expenditure of Hong Kong was relatively low, only constituting about 5.2% of Gross Domestic Product (GDP), and 2.8% of the public expenditure. As such, ADPL supported the continuous implementation of the existing medical system. Medical system and financing should not be changed drastically, but small changes should only be allowed to make on the existing basis.

(ii) ADPL considered that the small changes should aim at strengthening the promotion of the primary healthcare. The consultation document stated that population ageing would aggravate the medical expenditure in future. However, ADPL considered that the elderly aged 65 years old nowadays would be different from those twenty years later as they had gone through different growth processes and economic environment in Hong Kong and they had paid greater emphasis on health. If the future needs were projected based on the existing situation of the elderly, the medical expenditure incurred owing to population ageing would be overestimated.

(iii) The consultation document had put forward different financing options, and ADPL considered that the promotion of “Voluntary Private Health Insurance” should be stepped up. At the same time, the Government should strengthen the supervision of insurance system. He agreed that healthcare financing was required, but emphasis should be paid as to the additional resources collected through financing could be utilised to improve medical services. The Financial Secretary had suggested spending $50 billion as start-up fund, ADPL considered that it should be used to encourage the public to pay attention to personal health, subsidize “Voluntary Private Health Insurance” or implement tax waiver scheme for insurance expenditure. On the other hand, private insurance scheme should be monitored, including the preventive scheme (for example, body check). These might not be the most effective medical insurance scheme, but the Government should find out the most effective

olo/Dc[M4]_3 28

medical insurance scheme.

Mr. HO Yin-fai presented the paper titled as “Response to the Paper on “Your Health Your Life” Healthcare Reform Consultation Document” (annex 3) on behalf of the nine DAB members of WTSDC. DAB considered that the two principles of “fairness” and “three requests” should be upheld. Two principles of “fairness” included:

(i) Principle of Righteousness: The Government should continue to provide public medical services that met the standard so that each member of the public, no matter if they were rich or poor, could enjoy the protection of affordable medical safety net; and

(ii) Principle of Fairness: The future financing option must put into practice the principle of “Joint Commitment”.

“Three Requests” included:

(i) The related option must guarantee the sustainable provision of adequate resources at least until 2033 in the face of population ageing to maintain the existing service level;

(ii) No great burden would be caused to contributors or payees; also the option could give greater protection to the contributors;

(iii) The related option must be conducive to the balance of market share between public and private hospitals so that heavy reliance on public hospitals could be improved.

DAB considered that whichever supplementary financing options the Government designed, the following factors must be taken into consideration, including:

(i) Upward adjustment of the lower limit of the salary of the contributor in consideration of the affordability of the medium and low income groups;

(ii) When developing the Mandatory Private Health Insurance, consideration must be given as to whether the

olo/Dc[M4]_3 29

cover would include the costly critical illness or mainly the general medical insurance. With the prerequisite of causing no prejudice to the medical insurance of existing staff, the existing medical insurance plan could tie in with the future mandatory health insurance plan;

(iii) Developing stringent monitoring mechanism and establishing discussion platform with the service providers and users so as to handle the cover and carry out the consultation about the premium properly;

(iv) The Government must also study the rising trend of premium in future and consider capping the proportion of premium in wages to avoid causing excessive burden on the contributors for the payment of premium;

(v) Consideration could be given to set up the highest limit in savings when designing the mandatory savings plan, so that the high income group would not accumulate a sum of money more than required;

(vi) Considering the introduction of joint contribution with employers to realise the principle of shared commitment of a community;

(vii) Capitalising the provision of $50 billion and injecting the amount as the start-up fund, to bridge the difference after the capping of insurance expenditure and to alleviate the burden of contributors; and

(viii) The Government must also further alleviate the burden of contributors through tax-deduction arrangement.

Mr. HO Yin-fai said that the present environment gave no incentive for putting forward new policies. With the serious inflation meanwhile, the grass roots were most concerned with the price of daily necessities. He urged the Government to reconsider whether it was opportune to implement healthcare financing. He considered that discussion on healthcare financing were alright, but not decisions. 44. Mr. SHI Lop-tak, MH held the following four views towards healthcare financing:

olo/Dc[M4]_3 30

(i) Taking Care of the Middle-class and Providing Healthcare Insurance Incentive The consultation document stated that the target group of Mandatory Private Health Insurance was the middle-class with a monthly salary of above $15,000. He was compassionate towards this group of people with earning from $10,000 to $20,000. This group of low-income middle class people amounted to 1 million. They had contributed 5 % of their income for mandatory provident fund, with an extra 5% of their income for medical savings and insurance, they would face heavy financial burden. He suggested that the Government provided subsidy to these “lower middle-class” people with a percentage of about 1-2% to alleviate their burden.

(ii) Expanding the Coverage of Mandatory Private Health Insurance As regards the insurance scheme provided by the large insurance companies, the premium would be raised year by year or as age grew. When one fell ill suddenly, he or she would subsequently pay higher premium or would not be insured. On the other hand, for people earning more than $15,000, once they joined the Mandatory Private Health Insurance, they could pay 20 to 60% less than the premium for the same kind of insurance scheme of the large insurance company with one third to five times more of compensation. People falling ill could also be insured. People could enjoy the same premium irrespective of age. The more the number of participants, the lower the premium. As a result, employers could take out better insurance plan with the same premium. Better welfare could be provided for staff, which could help retain the talents. He also suggested the Government to provide tax deductions to encourage employers and citizens to take out mandatory medical insurance, and to make investments to pay for medical expenditure for citizens.

(iii) Establishing Electronic Health Record Database for Records to Follow Patients If a shared primary healthcare system could be established, primary healthcare personnel could establish

olo/Dc[M4]_3 31

stable, sustainable and trustworthy relationship with individuals and families. In this way, healthcare personnel could provide medical treatment to patients as well as give examination and assessment of the illnesses of patients. The physiological and psychological health of family members could be taken care of. Family doctor register as well as the electronic health record sharing were also recommended so that more professional community healthcare websites could be established for the public to choose doctors at their own free will. Healthcare personnel could also read the complete health record of patients with their consent to share community resources.

(iv) Using Primary Healthcare Vouchers that helped redefining the roles of public and private healthcare system, so that money went with patients.

(Mr. CHAN Wai-kwan, Andie left the meeting at 5:10pm.) 45. Mr. CHAN On-tai disagreed to changing the existing healthcare services, including the following reasons: firstly, Hong Kong Government had the responsibility to provide healthcare services; secondly, if the said cost was shifted to members of the public, it would be an inadequate measure. The crux of the problem was that members of the public had no idea how to protect oneself, the pressing task at the moment was to promote health education, so that members of the public knew how to protect oneself, thus minimising the suffering of illness and reducing personal medical expenses. In this way, the medical demand brought by the huge population would be reduced. On the other hand, the price of western medicine was getting higher, in the long term, reference should be made to overseas experience and study how the treatment of Chinese medicine could help members of the public improve their health. 46. Mr. MOK Ying-fan commented that “prevention was better than treatment”. He considered that the focus of medical reform should be changing the mindset of the public at the outset by motivating them to think whether money could bring health. People needed to pay heed to cycles, especially the cycles of living, eating and working. When people failed to live with this cycle, this would bring adverse effect. The reliance on medicine and machineries could only sustain life, but not the quality of life. He stressed that it was extremely important to pay attention to rules of

olo/Dc[M4]_3 32

living. (Dr. LAU Chi-wang, James, JP left the meeting at 5:15pm.) 47. Mr. WU Chi-wai, MH said Chapter 2 of the consultation document “Enhancing Primary Care” mentioned that discussion about improvement of primary care had commenced since 90’s, sixteen to seventeen years had passed, and the progress was limited. The development of electronic health record sharing and the register of family doctors were also closely related with primary care. Obviously, “preventive care” and primary care were the keys of the healthcare system. Nevertheless, the development was far from satisfactory. The first question was why the Government would think that the supplementary financing could improve the status quo of primary healthcare system; secondly, if the Government set 17 % as the upper limit of medical expenditure from now on till 2033, there would be $130 billion of deficit in medical expenditure. The deficit would be settled by all contributors, otherwise, there would be a lack of sufficient money to provide medical services. If this was the case, the burden of contributors would be heavier. The Government must study how to strike a balance between medical expenditure and burden of contributors, so that contributors could feel at ease in making contribution. He doubted if taking out insurance was the only way to solve the imbalance between public and private hospitals and encourage patients to use the services of private hospitals. The Government must make changes in the system to solve the problem of imbalance. In a meeting of an area committee, the members opined that the Government should follow two principles when developing any option, one was that the principle of fairness must be upheld for sharing of medical expenses to achieve the effect of wealth redistribution, i.e., those who afforded to pay should pay more, not those who were healthy to pay more. Secondly, the principle of “money followed patients” should be upheld. 48. Mr. TO Kwan-hang, Andrew pointed out that the Government should firstly review the two policies relating to charges of Accident & Emergency (A&E) ward and drug formulary before implementing healthcare financing. He reiterated that the Government should firstly rectify various policies that cut medical expenditures owing to financial restraint in the past before studying how to ask people to supplement the financing. The existing healthcare system in Hong Kong followed NHS (National Health Service) of England, i.e., the Government paid for medical expenses for the public from tax revenue. This system had no serious drawbacks. In terms of longevity and low mortality, Hong Kong attained the world-class level. Given this excellent healthcare

olo/Dc[M4]_3 33

performance, why should there be changes? According to Annex D of the consultation paper, other countries relied on tax revenue to pay for medical expenses, owing to the low tax rate in Hong Kong, the needs could not be fulfilled. This was equivalent to putting the incidental before the fundamental. As the Government paid the medical expenses from tax revenue, why didn’t they continue to do so? He did not think that a contribution of 5% from the salary of the working population could cope with the needs of medical services. The financial burden of contributors of healthcare financing would only rise up with greater percentage of contribution. On the other hand, he shared the views of Mr. CHAN On-tai and Mr. MOK Ying-fan that other kinds of healthcare method should be introduced to help solve healthcare problems. Medical system in Hong Kong was dominated by Western medicine, as a result, the cost of medical services ran higher, leading to medical inflation. If healthcare market was not open, medical cost would only run high persistently, while the Government could not bear the cost brought by population ageing. 49. Mr. CHUI Pak-tai supported the views of ADPL. He was worried that the Mandatory Private Health Insurance would repeat the same mistakes of Mandatory Provident Fund. The Mandatory Provident Fund had made the society suffer a great deal, affecting some of the industries and economic development, freezing part of the social capital and incurring social and economic loss. This capital mainly came from lower class, which was liquid capital. The healthcare policy nowadays in Hong Kong was successful, and he showed reservation towards the horrifying data and predictions given by the Government. There were a lot of savings that could be made in the healthcare system, for example, community healthcare could help reduce the healthcare cost. As far as he knew, the daily operating cost of hospital beds in public hospitals was approximately $3,000, on the contrary, the daily operating cost of private hospital beds was cheaper than that of public hospital beds. If the cost could be reduced, the expenditure of healthcare services would certainly be reduced. 50. Mr. WONG Kam-chiu supported Mandatory Private Health Insurance, but the needs of middle class and low-income group should be taken care of. A tier-system for contribution should be set up with different rate of contribution for different groups of people. 51. Mr. MOK Kin-wing raised a few queries and put forward a few suggestions towards healthcare financing. Firstly, if healthcare cost was shifted to insurance companies, would there be a rise in overall healthcare expenditure? Secondly, the healthcare services were monopolised by public hospitals, and the high cost had always been criticised by people.

olo/Dc[M4]_3 34

Was it the result of a lack of competition? He suggested further developing the system of healthcare vouchers, so that it could cover public hospitals. He suggested incorporating healthcare services provided by non-government organisations in the area of public-private partnership. On the other hand, the Government should explore other means to subsidise local healthcare services. He considered that the retired persons should be taken care of in the transitional period when healthcare financing reform was introduced. In short, he considered that there should be less financing but more reform, economising on expenses before tapping new resources. 52. Mr. MOK Chung-fai, Rex said that there were five suggestions for healthcare reform, firstly (1) enhancing primary care; (2) promoting public-private partnership; (3) developing electronic health record sharing; (4) strengthening public healthcare safety net; (5) reforming healthcare financing arrangements. There was wide coverage on item 5 and so items 1 to 4 were ignored. There was the proposal of “money went with patients”, i.e., members of the public could utilise resources to purchase private healthcare services, however patients had no idea on the charges of private doctors and how to find suitable doctors. In USA, private doctors would list all the charges and the success rate in performing surgeries. Secondly, “family doctors” was also a new concept to local doctors. It was suggested that the Government illustrated this concept in the second phase of consultation. The third one was about primary care services, he suggested that the promotion of prevention should be strengthened by means of public education. On the other hand, he also suggested an improvement to the term “primary care’ as people would mistake this as medical services for the lower-class. He suggested improving the Chinese translation. (Mr. TO Kwan-hang, Andrew left the meeting at 5:45pm.) 53. Dr. CHOW made a consolidated reply towards the questions and comments of Members as follows:

(i) Mr. HUI Kam-shing asked if healthcare reform would bring great changes, all the changes were made on the existing basis, not drastic ones. Changes would be made step by step. The existing strategy was to fix the objectives of all services and implement them step by step. On the other hand, different public-private partnership projects would be launched, for example, purchasing private services, healthcare vouchers for the

olo/Dc[M4]_3 35

elderly. These could test the capacity of the market, the choice of service providers and members of the public so that the working needs in future could be understood.

(ii) The existing medical expenditure only constituted a small proportion of GDP. As compared with other countries where medical expenditure constituted a high proportion in GDP, the tax rate in Hong Kong was low, unless the tax rate was raised substantially, otherwise the level of these countries could not be reached. Given the low tax-rate environment, it was important to rationalise the limited resources.

(iii) There was the proposal to change the name “primary care”. In fact, “family doctor” was the more appropriate term. The concept was that a doctor could establish long-term relationship of mutual trust with a family. The doctor could understand the living pattern and health status of the patient and so could give better treatment. Overseas experience showed that patients were satisfied with family doctors much more than other doctors. On the other hand, strengthening primary care could minimise repeated and unnecessary service needs, this would save cost.

(iv) He had also watched the movie “SICKO”. The healthcare system in USA created a lot of problems, which was not a good model for Hong Kong. The medical expenditure in USA constituted about 15% of GDP, about 5% was used for the paid services of the third party, constituting a high percentage, in other words, a substantial amount of it was spent for insurance companies and lawyers. At present, Hong Kong had not wasted money on the paid services of the third party.

(v) FHB agreed to the requests and recommendations put forward by the nine DAB Members. The “eight considerations” were equally important and some of them were feasible. As regards whether it was opportune to implement reform, the “opportune time” was indeed non-existent. Healthcare reform could not be carried out only when crisis came or when the system collapsed. This was irresponsible and would cause tragedy. In

olo/Dc[M4]_3 36

view of the relatively stable economic environment at present, it was opportune to carry out reform. Meanwhile, the Government had pledged to increase the medical expenditure from 15 % to 17 %, amounting to about $10 billion of recurrent expenditure. The Financial Secretary had also pledged to use $50 billion as the start-up fund to help the participants, especially the low-income group.

(vi) In relation to the views of Mr. SHI Lop-tak, the middle-class was the group which the Government had shown the greatest concern. They were the ones paying tax on one hand, and using private medical services and taking out medical insurance on the other. Even though they could afford to pay for the services, the charges for private medical services were on the rise. If private market was allowed to operate freely, the situation would deteriorate. As such, the Government needed to implement measures at the appropriate time to control the increase of cost and charges. On the other hand, the Government would also study the way to offer tax concession for both employers and employees taking out Mandatory Private Health Insurance.

(vii) The proposed “family doctor register” would enumerate the professional qualifications and information about doctors in the register to facilitate the public to find suitable doctors. At the same time, it could prevent doctors from advertising for themselves and thus leading to unhealthy competition.

(viii) The Government shared the views of Mr. MOK Ying-fan and Mr. CHAN On-tai about promotion of Chinese medicine and healthy life. Members were encouraged to attend the Summit on District Administration held on 10 May 2008 to express their views about promoting the message on healthy life in the community and minimising healthcare needs. Body functions would decline when one grew older, falling ill was inevitable, therefore, the Government must safeguard the health of the public.

(ix) Mr. WU Chi-wai showed his concern about the relationship between healthcare financing and healthcare

olo/Dc[M4]_3 37

services. Apart from the four main services (i.e., taking care of the poor and underprivileged, providing accident and emergency services, treating critical illnesses/ providing hi-tech/high risk/costly medical services and training healthcare personnel) provided by HA, the Government hoped that the concept of “money followed patients” could be realised in other healthcare services. Reform could only be brought by financing. Not everybody could understand the data in the consultation document, but these data were made following international standard through repeated examination. They were considered reliable and could be used as reference for the public.

(x) As regards the views of Mr. TO Kwan-hang, Andrew about charges for A&E department and drug formulary, the Government implemented these measures not for saving expenditure. The levy of charges for A&E services aimed at triaging non-A&E patients to other clinics, private doctors or general out-patient clinics. The proceeds from the charges were not much. At the early stage of implementation, the attendance of non-A&E patients decreased, but about 50 to 60% of patients at present were not in genuine need of emergency treatment. They only treated A&E department as family medical services. Any society with public healthcare organisations would have established drug formulary. This was established for giving proper drug treatment to the public under the principle of fairness. The drugs in the formulary were jointly decided by a group of professional doctors, not solely by the Government.

(xi) The Government appreciated the worries of Members towards MPF, the accumulated amount at the beginning was relatively less, however the amount had increased continuously. The experience would be taken into account in implementing medical insurance scheme.

(xii) As regards the cost of hospital beds, the daily charge of beds in private hospitals surely exceeded $3,000, exclusive of surgery fees and other charges. Conversely, the daily operation cost of public hospital beds was about $3,000, inclusive of charges of other

olo/Dc[M4]_3 38

items. Moreover, HA had to handle a substantial number of rare and complicated cases which required a lot of manpower and resources. The stance of the Government was to control medical cost as far as possible on one hand and maintain the service level to a certain extent on the other.

(xiii) The Government would consider the proposal to set different levels of contribution for different people with different salaries. This proposal was complicated and not easy to implement. The Government hoped to implement a simple administrative system so that the future financing system could be more efficient.

(xiv) Some Members opined that HA lacked enough competition and suggested inviting non-government organisations to provide services. All HA needed was healthy competition, otherwise, the level of medical services would decline. In relation to the selling of healthcare services to attract foreigners to come to Hong Kong to seek treatment, the obstetrics services had been widely used, but it was not the original intention of the Government. The proposal would only be considered when there was room to do so. Under the new policy, the Government would also pay attention to the medical need and arrangement for the retired persons.

(xv) Mr. MOK Chung-fai mentioned that only financing options had been widely discussed, reform proposals in items 1 to 4 were not discussed as much, as most of the people would just attach importance to expenditure. The Government hoped that the public would understand that the healthcare reform not just touched on financing, but also the overall medical system and the solution for the input of healthcare resources. The reform would not only last till 2033, the Government hoped that a sustainable and good mechanism could be set up to provide stable medical services. In view of the different economic cycles and fluctuations in Hong Kong, there was a need to provide sustainable resources and services, which was also one of the objectives of medical reform.

(xvi) Chinese medicine was important medical service, but it

olo/Dc[M4]_3 39

could not replace traditional Western medicine. There was room for the development of Chinese medicine. The Government hoped that Chinese medicine clinics could be set up in 18 districts, and the trial scheme for the merging of Chinese and Western medicine had been launched in several hospitals. The proposal to set up Chinese medicine hospital was also being studied. The Government hoped to balance the development of all healthcare industries.

(Mr. CHUI Pak-tai left the meeting at 5:55pm.) 54. Mr. MOK Ying-fan clarified that he was not suggesting the replacement of Western medicine by Chinese medicine as the mainstream service, but he hoped that they could coexist. He observed that Chinese medication had an edge over long term illness. 55. The Chairman said that the consultation period for the document would last until 13 June 2008. Members could forward their views to FHB through fax, post and e-mail. 56. The Chairman concluded that WTSDC welcomed the issue of “Healthcare Reform Consultation Document” by the Government. As population ageing in Hong Kong was becoming serious, the demand on the quality and provision of healthcare services would surely become greater. There was a need for healthcare reform, but it was hoped that the Government would first take into account the affordability of the public when implementing any supplementary healthcare financing options. At the same time, the policy that “no one should be denied adequate healthcare through lack of means” must be maintained. The Government must increase its commitment, while the public healthcare system must continue to take care of the low-income family and the underprivileged. 57. Mr. CHAN On-tai added that healthcare financing could not solve the needs of the public and hoped that FHB could promote self-education for psychological and physiological health. 58. Dr. CHOW welcomed the expression of views by members from different sectors. FHB had also set up consultation websites for browsing. 59. The Chairman thanked Dr. CHOW, Ms. LEE and Ms. AU to attend the meeting.

olo/Dc[M4]_3 40

(Dr. CHOW Yat-ngok, Ms. LEE Suk-yee and Ms. Christine. AU left the meeting at this juncture.) III (iv) Independent Commission Against Corruption Regional Office

(Kowloon East/Sai Kung) Work Plan 2008/2009 (WTSDC Paper 35/2008) 60. The Chairman welcomed Mrs. TAM CHEUNG Kwei-ying, Dorothy, Regional Officer (Kowloon East/ Sai Kung) and Mr. W. L.CHAN, ICAC Officer to attend the meeting and introduced the paper on Independent Commission Against Corruption Regional Office (Kowloon East/Sai Kung) Work Plan 2008/2009. 61. Mrs. TAM CHEUNG Kwei-ying presented the paper “Independent Commission Against Corruption Regional Office (Kowloon East/Sai Kung) Work Plan 2008/2009” with audio-visual aid, the highlights were as follows:

(i) Independent Commission Against Corruption Regional Office (Kowloon East/ Sai Kung) also held different kinds of anti-corruption activities for people living and working in Wong Tai Sin, Kwun Tong and Sai Kung apart from receiving anti-corruption complaints and providing consultation services for the public, thus promoting the culture of integrity.

(ii) The work plan this year was mapped out to tie in with the characteristics and needs of this district, and Community Relations Department (CRD) also assisted in formulating it in response to the corruption trend, economic development, social appeal and development of corruption work.

(iv) Last year, there was a rise of 8 % in the overall reporting of corruption case, reaching the number of 3600 cases. Corruption in the Government departments had declined, however, there was a rise of the corruption cases in private and public organisations. Over 60% of the cases involved private organisations, among them, building management constituted the greatest amount, approximately 40%.

olo/Dc[M4]_3 41

(v) There were six focuses of the work plan 2008/2009 as

follows: (a) Community Anti-corruption Activities: The 18

districts in Hong Kong would adopt “Integrity and Quality Building Management and Maintenance” as the theme, which enabled people from different classes to understand the importance of integrity building management. Regional Office (Kowloon East/ Sai Kung) would combine social resources and continue to cooperate with WTSDC, Wong Tai Sin District Office (WTSDO) and Wong Tai Sin District Fight Crime Committee (WTSDFCC) to mobilise more district organisations to participate in anti-corruption work.

(b) Building Management Service: In view of the

persistently great number of corruption complaints relating to building management, (while more than half of the reporting involved the tendering and supervision about works or services contracts), ICAC would strengthen the cooperation with the Home Affairs Department (HAD), related Government departments and HKHS to implement a series of activities that promoted integrity building management.

(c) Youth Services: CRD had visited all the universities in

Hong Kong since 2007, and would finalise all detailed cooperation plans this year, including arranging talks for students from the Mainland and overseas and students of associate’s degree apart from contacting undergraduates. Interactive Theatre of Secondary School Students would continue to be held. On the other hand, CRD would also hold Integrity Ambassador Scheme with the City University of Hong Kong. Youth Uniform Groups would also cooperate with “ICAC Club” to organise integrity projects and continue to promote moral education among youngsters.

(d) Clean Election: CRD would continue to cooperate with

Electoral Affairs Commission (EAC) and Registration and Electoral Office (REO) to carry out suitable

olo/Dc[M4]_3 42

education and promotion work for the 2008 Legislative Council Election to promote the “Support Clean Elections” message.

(e) Business Sector: ICAC would strengthen the integrity

management and leadership of the directors of the listing companies. On the other hand, corruption prevention services would be provided to the Small and Medium Enterprises (SMEs) participating in cross-boundary operation, and ICAC had collaborated with the Guangdong Provincial People’s Procuratorate to produce a “Corruption Prevention Guide for SME Entrepreneurs Investing in Guangdong”. A seminar would be held in mid April to distribute the Guide to SME Merchants Association. As regards the corruption prevention recommendations for the catering industries, ICAC would cooperate with the related merchants association to promote corruption prevention services and publicise corruption prevention messages. For the insurance industry, ICAC would launch a two-year professional ethics programme for the industry in partnership with the Office of the Commissioner of Insurance and six self-regulatory bodies and key professional associations, also, they would also provide a training package comprising a filmlet on managing staff integrity and a corruption prevention guide to the insurance sector. CRD would also develop new talk contents for the Continuing Professional Development Courses for managers and frontline insurance practitioners, and organise a series of professional ethics seminars in collaboration with key players in the industry.

(f) Public Sector: To entrench the culture of probity in the

civil service, ICAC would continue its long-term cooperation with the Government departments in launching an Ethical Leadership Programme. Under the programme, “Ethics Officers” of Directorate ranks from each policy bureau and department would be appointed to share their experience through workshops and explore topics of common concern. With increased outsourcing of services by Government departments and public organisations in recent years,

olo/Dc[M4]_3 43

ICAC held anti-corruption talks to assist departments in enhancing their awareness in anti-corruption for the management of outsourced contracts.

ICAC hoped that WTSDC would continue to support its work. 62. Mr. CHAN Yim-kwong was concerned with corruption of building management and maintenance. There were a great number of private buildings in his constituency, and there were always the problem of building management and maintenance. He had known two cases and he wanted to seek the comments of ICAC. The first case involved a subsidiary management company of a large real estate developer. The management company told the OC that as the quality of the maintenance companies in the market varied, they advised not to conduct open tendering, but employ the consultancy and maintenance company of the same group to take up the works. The second case involved the tendering of a building maintenance works that cost over $10 million. One of the tendering companies was considered the best and had a high chance of being selected by the OC. However the management company claimed that it seemed the tendering company was under ICAC’s investigation, and so the OC decided not to employ the tendering company to take up the works. He sought ICAC’s advice on the cases. 63. Mr. SO Sik-kin supported ICAC’s work and gave special praise to the “Integrity and Quality Building Management and Maintenance” scheme, as OCs and management companies had to take up a lot of management and maintenance work, clear guidelines could help OCs and management companies to have a better understanding. As such, he hoped that ICAC could publicise and promote the scheme further. 64. Mr. LEE Tat-yan, MH said that as ICAC had mentioned a lot of complaint cases about building management and maintenance, he suggested ICAC to publicise the typical cases in the newspaper, and promote the way ICAC handled cases and conducted trial for the reference of the related persons. He reflected that some owners made use of ICAC law to obstruct proper building maintenance, and always claimed that they would lodge complaints to ICAC about building maintenance. These acts seriously affected the proper operation of OCs, he claimed that when ICAC promoted the law, they should also stress the adverse effect and consequence of abusing the functions of ICAC. 65. Mrs. TAM CHEUNG Kwei-ying gave a consolidated reply towards the questions and comments raised by Members as follows:

olo/Dc[M4]_3 44

(i) In relation to all the acts that obstructed tendering or building maintenance, ICAC had publicised “The Building Management Toolkit” to illustrate clearly all the steps and points to note in building maintenance. OCs could refer to the toolkit for reference, call the hotline of ICAC or contact the staff of CRD to seek opinions about the special case of the building.

(ii) The interest of buildings and building owners came first to OCs. In the course of building management and maintenance, keeping high transparency and documenting each step could protect the interest of buildings as well as the interests of the related persons.

(iii) When carrying out publicity, ICAC would only stress the proper way to handle management maintenance and management, as well as stressing the need of keeping high transparency, making proper record and maintaining good communication so as to minimise misunderstanding and the chances of being complained.

(iv) ICAC hoped that OCs could obtain a clear reference after they had issued the toolkit, set up the hotline and launched the homepage.

66. Ms. KWOK Sau-ying commented that since the Regional Office moved away from Wong Tai Sin, she felt that the communication between ICAC and district residents had decreased. She hoped that ICAC could strengthen publicity in the district and re-establish communication with the public. She also suggested ICAC to publicise the ‘tea gatherings’ further. On the other hand, she asked if the inadequate manpower of CRD affected the close relationship between ICAC, district organisations and DC Members. (Ms. TAM Yuet-ping, Celia left the meeting at 6:35pm.) 67. Mrs. TAM CHEUNG Kwei-ying replied that their resources and manpower were limited, however they would do their best. If any district organisations liked to know more about the work of ICAC or pay a visit, they could pass the information to ICAC for following up. She thanked Members for their support and valuable opinions, and promised to follow up.

olo/Dc[M4]_3 45

68. The Chairman asked Members to note the work plan of ICAC and urged them to give continuous support to all community activities of ICAC. He also asked ICAC representatives to note the opinions of Members. (Mrs. TAM CHEUNG Kwei-ying and Mr. W.L CHAN left the meeting at this juncture.) IV. Progress Reports (i) Progress Report of the 3rd Meeting of the Community Building and

Social Services Committee held on 18.3.2008 (WTSDC Paper 36/2008) 69. Members noted the paper. (ii) Progress Report of the 3rd Meeting of the Finance, General and

Economic Affairs Committee held on 25.3.2008 (WTSDC Paper 37/2008)

70. Members noted the paper. (iii) Progress Report of the 3rd Meeting of the District Facilities

Management Committee held on 1.4.2008 (WTSDC Paper 38/2008) 71. Members noted the paper. (iv) Progress Report of the 3rd Meeting of the Traffic and Transport

Committee held on 8.4.2008 (WTSDC Paper 39/2008) 72. Members noted the paper. (v) Progress Report of the 3rd Meeting of the Housing Committee held

on 15.4.2008 (WTSDC Paper 40/2008) 73. Members noted the paper.

olo/Dc[M4]_3 46

(vi) Progress Report of the 3rd Meeting of the Food and Environmental Hygiene Committee held on 22.4.2008

(WTSDC Paper 41/2008) 74. Members noted the paper. (vii) Progress Report of the 3rd Meeting of the Working Group on

Government and Public Utilities Works Projects held on 29.4.2008 (WTSDC Paper 42/2008) (on table) 75. Members noted the paper.

(viii) Progress Report of the Meeting of the Wong Tai Sin District

Management Committee held on 11.4.2008 (WTSDC Paper 43/2008) 76. Members noted the paper.

V. Any Other Business 77. The Chairman informed Members that to echo the 2008 Beijing Olympic, WTSDC established Wong Tai Sin Olympics Organising Committee in early 2008, and Mr. WONG Kam-chi, the Vice-chairman of WTSDC was elected the Chairman of the Organising Committee. The four working groups under the Organising Committee would organize a series of projects for promoting Olympic Games. On the other hand, he congratulated Mr. WONG who acted as torchbearer for the torch relay on 2 May on behalf of WTSDC.

VI. Date of Next Meeting 78. The 5th meeting of WTSDC would be held on 8.7.2008 (Tuesday) at 2:30pm. 79. There being no other business, the meeting adjourned at 6:40pm. Wong Tai Sin District Council Secretariat Ref: WTSDC 13-5/5/53 Pt 16 June 2008

olo/Dc[M4]_3 47

Note: Should there be any discrepancies between the Chinese and English versions, the Chinese version shall prevail. This English summary translation is for reference only.

Annex 1 [Minutes of WTSDC Meeting held on 6.5.2008] Ref: WTSDC/08/0506 To: WTSDC Chairman and all Members

Views and Recommendations about Effective Control of Private Buildings

In view of water seepage, demolition of illegal structures and

standardization of signboards of private building handled by the Buildings Department (BD), I have the following views and recommendations: 1. Handling Water Seepage in Private Buildings

In view of serious water seepage in private buildings, BD and the Food and Environmental Hygiene Department (FEHD) established a Joint Office to dedicate their effort in handling water seepage in private buildings. However, since the establishment of the “Joint Office” in 04, the number of successful cases was minimal. The complaints lodged by the public towards water seepage in buildings have been rising instead of declining, above all, the speed with which the “Joint Office” handled water seepage is slow. FEHD and BD shirk their responsibilities, which render owners affected by water seepage suffer from different degrees of mental stress. “Joint Office” is just bearing a name only, and its achievements have been exaggerated. I think that BD should allocate resources to strengthen the function of the “Joint Office” as soon as possible and amend the related legislation suitably to punish those obstinate and uncooperative owners. 2. Inadequate Coordination Relating to the Issue of “Order”

BD selects target buildings in each district each year for demolition of illegal structures and issuing maintenance order in order to obtain the understanding of and earn the support of the public. However, as there is inadequate internal coordination within BD, the grass-roots

public finds it hard to adapt to it, and they have a feeling of being slaughtered. For example, take Yu Foo Building in San Po Kong as an example, the building received the demolition order from BD to demolish roof-top structures in 03, it then received the maintenance order again in 04, the owners of the uppermost floor also received the demolition order from BD to demolish illegal structures in 05, and these owners also received the order to demolish railings in 07. All these reflected that there was a lack of internal coordination. A group of small owners are like “Peking Duck”, being slaughtered once each year. They do not only bear great economic cost, but also suffer from continuous mental stress. I consider that BD should issue one-off order to protect the interests of grass-roots public. 3. Different Standards for the Demolition of Illegal Structures

Dubious Effect in Registering the Warning Notices Against the Title of the Subject Premises in the Land Registry

In recent years, BD has taken a number of measures to handle illegal structures in private buildings, including demolition of roof-top structures, rooftop platforms and so on. However, under the principle that buildings with no imminent danger will not be accorded the priority, BD allows some illegal structures to exist for a long time by adopting different standards. Moreover, by means of registering the warning notices against the title of the subject premises in the Land Registry, BD allows the owners owning illegal structures to get rid of the order for immediate demolition. This is extremely unfair to those owners complying with the law. I consider that BD should amend the legislation as quickly as possible and abolish the registration of warning notices against the title of the subject premises by allocating the resources to strengthen patrol and prosecution. 4. Standardisation of Signboards of the Related Shop Premises

In recent years, shop tenants received the order from BD, which required them to reinstall signboards according to the specifications of BD. Those shops have been in operation for some years, and those signboards have been in use till now. They do not cause “immediate danger” as stated by BD. However BD insists on enforcing the order by

requiring shop tenants to make improvements within the deadline, otherwise, they will be prosecuted. Shop tenants have reflected that the specifications for the signboards have been in use for over thirty years, and no Government departments have interfered with it. They have no idea that the signboards fail to meet the requirements. I consider that if no immediate danger is caused by the signboards, BD should give grace period to shop tenants, for example, replacing signboards when maintenance work is being carried out or modifying the design according to the specifications when there is a changeover of shop tenants. 5. Strengthening the Publicity for Better Effect

In enacting or implementing new legislation, for example, the newly amended “Fire Services Ordinance”, BD should make widespread publicity in newspaper, radio stations, televisions, posters, pamphlets and road show on the bus. I consider that in implementing or executing new legislation, BD should use at least one year for publicity education, so that the public can be familiar with the contents of the ordinance to avoid being prosecuted for contravening it.

WTSDC Member LEE Tat-yan 24.2.2008

Annex 2 [Minutes of WTSDC Meeting held on 5.6.2008] To: WTSDC Chairman and all Members

Initial Comments of Hong Kong Association for Democracy and

People’s Livelihood (ADPL) towards “Your Health Your Life Healthcare Reform” Consultation Document

Principle and Rationale Behind Healthcare Reform Policies 1. The commitment of the Government towards medical expenditure cannot be equivalent to “commercial behavior” or “a sum of money”, after “education” has been considered as investment. The Government makes use of the pretext like social commitment, income falling short of expenditure, or expenditure in excess of revenue to describe the future medical expenses, which shows a very narrow point of view, and neglects the social functions that medical policies give play to. 2. The Government has implemented the medical policies that advocates charging comparatively cheap medical cost, which can help stabilize the society and cool off the excessive expansion of wages, so as to reduce the operating cost. The rationale behind it is to improve the livelihood of the public, and safeguard the right of everyone for “medical treatment for illness”. As such, the deep-rooted impact should be considered. Under this prerequisite, we consider that any medical reform and financing must keep the existing medical system, including the existing low-cost medical fee charging system and so on. It is appropriate for the Government to make suitable changes within the existing basis and improve the existing system. 3. The past medical financing option of the Government was not only effective, but could also provide quality services with suitably-controlled cost. The overall medical expenses in Hong Kong nowadays have constituted a comparatively low proportion to Gross Domestic Product (GDP). In 2004, it constituted about 5.3 % (In terms of the strong economic growth in recent days, the figures may have been lower) and the Government expenditure only constituted 2.9%. Compared with 8-15% in Government expenditure in other developed regions, the figures

of Government expenditure were low. Based on the projection made in the consultation document, the total medical expenditure in Hong Kong will only account for 9.2% of GDP in 2033, among them, 5.5% is Government’s expenditure. It can be seen that the future medical commitment of the Government is even lower than that of other developed economies. Put the Incidental before the Fundamental 4. The consultation paper has repeatedly stressed that the rise of medical expenses is due to population ageing, the way of urban living that has led to the incessant increase in morbidity rate (for example, high blood pressure, colon cancer) and the rise in medical cost. In particular, “population ageing” has always been described as the future “burden”, the description is rather negative. We have been advocating the need to establish comprehensive and well-established facilities to cope with the challenges posed by population ageing, for example, establishing territory-wide retirement protection scheme and developing the substantial “Silver Market” to give full play to the potential of the elderly. We should not treat population ageing as serious social problem, conversely, it should be treated as the challenges faced by many developed countries, the key to solve the problem is the way to adjust to it. 5. Indeed, medical reform must tackle the root of the problem and money is not the panacea. The most effective way is to encourage people to have a healthy living style. It does not only include strengthening primary healthcare service, such as creating a register of family doctors and subsidizing patients to exercise preventive care, but also make good coordination in different policy areas, not just in medical care, but also in education, home affairs, labour, commerce, environmental protection, city planning and so on. The Government must get rid of the passive method of healing the illness but eliminate the problem at source. 6. We know that urbanization and unhealthy way of living contribute to the long term rise in the medical expenditure. Then, should we alter this living style? The Government is not only required to promote environmentally simple life, but should also look into the unhealthy lives

brought by urbanization, for example, serious air pollution, prolonged working hours, the lack of exercises, junk food and so on. As such, healthy diet should be adopted from young age; providing incentives and setting up more recreational and sports facilities to encourage the public to do more exercises; finalizing “Food Labelling Ordinance” as quickly as possible; strengthening the control on food safety; rationalizing smoking ban policies, improving air quality and urban planning, or even restricting the advertisement about junk food. These measures will certainly reduce the pressure in raising medical expenditure. 7. Moreover, with the rise in medical cost, including the advance in medical technology, the cost can be cut by means of cost control and structure simplification. On the other hand, apart from western medicine, Chinese medicine should also be introduced. This traditional medicine is not only lower in cost, but can also preserve one’s health and restore one’s health. Unfortunately, with western medicine as the mainstream treatment, Chinese medicine lacks the room for development, as can be seen from the consultation paper this time that “Chinese medicine” is not mentioned. At present, the medical cost is expanding only along with the expansion of western medical system. In view of the lack of holistic treatment, with the adoption of counter-attacking treatment and the repeated study of the same problem, how come there was no rise in medical cost? No Repetition of the Same Problem as “Mandatory Provident Fund” 8. On the other hand, among different kinds of medical financing, mandatory health insurance and medical savings accounts are the premier choices of the Government. However based on foreign experience, the introduction of mandatory health insurance and medical savings accounts has no guarantee for bringing substantial benefits to medical quality and financing. Conversely, it will lead to the introduction of irrelevant insurance industry and fund managers that nibble up the tight medical expenses. What is even worse is that future medical fee, treatment method and use of drugs will become pure commercial decision instead of professional medical judgement. 9. As such, we consider that for any medical reform, the existing medical financing system must be maintained. It is only appropriate for

the Government to make due changes and rationalize the existing system under the existing basis, including the maintenance of existing medical system and financing arrangement; suitably controlling medical cost and streamlining the medical structure; setting up medical treatment fund with tens of billions of earmarked sum of the Government; introduction of Chinese medicine treatment; strengthening the regulation of the existing medical insurance; providing incentives to encourage the public to take out “regulated” insurance at their own free will; enhancing the promotion of primary healthcare services and promoting territory-wide healthy living within coordinated policy areas. ADPL WTSDC Members MOK Ying-fan HUI Kam-shing

Annex 3 [Minutes of WTSDC Meeting held on 5.6.2008]

Ref: L/WTS/DC/20080506 To: WTSDC Chairman and all Members

Response to the Paper on “Your Health Your Life” Healthcare Reform Consultation Document

We agree that the public healthcare system is facing the inadequacies of resources which lead to a decline of service quality and exceedingly long waiting hour for consultation. Moreover, the situation will deteriorate based on the projection of the Government. We consider that the Government should put forward effective measures at this stage to enforce the role of primary healthcare services, set down the specific policies and timetable for implementing the system of family doctor, strengthen the prevention of diseases and reduce the hospitalization need of residents. On the other hand, the effectiveness in the usage of public medical resources must be enhanced, and the cooperation of public and private hospitals must be promoted to control the growth of medical expenditure; meanwhile, adequate healthcare staff should be trained proactively to cope with the increasing medical service need brought by population ageing. We also urge the Government to develop measures to effectively monitor the service level of private medical services and make the fee standard transparent to facilitate the expansion of private hospitals. The development of non-profit making private hospitals was encouraged through policy-making to improve the existing excessive demand on hospital beds in private hospitals and provide private in-patient services for those people who are well-off. We agree that the society has the need to continue exploring the option for seeking additional resources to ensure that adequate resources were in place to maintain the existing service level of public medical services to guarantee that the Hong Kong public still could enjoy the protection of medical safety net.

We consider that the two principles of “fairness” and three requests must be pressed no matter which supplementary financing options would be studied. The two principles of “fairness” include:

Principle of Righteousness: The Government should continue to provide public medical services that meet the standard so that each member of the public, no matter if they are rich or poor, can enjoy the protection of affordable medical safety net;

Principle of Fairness: The future financing option must put into practice the principle of “joint commitment”.

Three Requests include:

The related option must guarantee the sustainable provision of adequate resources at least until 2033 in the face of population ageing to maintain the existing service level;

No great burden will be caused to contributors or payees; also, the option can give greater protection to the contributors;

The related option must be conducive to the balance of market share between public and private hospitals so that heavy reliance on public hospitals can be altered.

Among the six supplementary financing options put forward by the Government, “Personal Healthcare Reserve” comparatively complies with the abovementioned requests in principle at the outset, which can be discussed in depth. However as the option still lacks specific contents and data, we hope that the Government could submit more solid contents and substantial data in the second stage of consultation so that the public can make suitable choice with adequate information. We consider that the Government must take into the following factors into serious consideration when working out the specific contents of any supplementary financing options, including: (i) Upward adjustment of the lower limit of the salary of the

contributor in consideration of the affordability of the medium and low income groups;

(ii) When developing the mandatory health insurance plan, consideration must be given as to whether the cover will include

the costly critical illness or mainly the general medical insurance. With the prerequisite of causing no prejudice to the medical insurance of existing staff, the existing medical savings plan can tie in with the future mandatory health insurance;

(iii) Developing stringent monitoring mechanism and establishing discussion platform with the service providers and users so as to handle the cover and carry out the consultation about the premium properly;

(iv) The Government must also study the rising trend of premium in future and consider capping the proportion of premium in wages to avoid causing excessive burden on the contributors for the payment of premium;

(v) Consideration can be given to set up the highest limit in savings when designing the mandatory savings plan, so that the high income group will not accumulate a sum of money more than required;

(vi) Considering the introduction of joint contribution with employers to realize the principle of shared commitment of a community;

(vii) Capitalising the provision of $50 billion and injecting the amount as the start-up fund, to bridge the difference after the capping of insurance expenditure to alleviate the burden of contributors.

(viii) The Government must also further alleviate the burden of contributors through tax-deduction arrangement.

DAB (WTS Branch) WTSDC Members KAN Chi-ho, BBS, MH LI Tak-hong, MH LAI Wing-ho, Joe HO Yin-fai, HO Hon-man LAM Man-fai, JP CHAN Man-ki, Maggie MOK Kin-wing WONG Kwok-yan 6 May 2008